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Wodak, Alex; Crofts, Nick |
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Title |
Once more unto the breach: controlling hepatitis C in injecting drug users |
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Journal Article |
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1996 |
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Addiction |
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91 |
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2 |
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181-184 |
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health promotion |
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50-02838 |
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59763 |
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various |
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Education& debate : Risks to surgeons and patients from HIV and hepatitis: guidelines on precautions and management of exposure to blood or body fluids : joint working party of the Hospital Infection Society and the Surgical Infection Study Group |
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Year |
1992 |
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British medical journal |
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305 |
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28.11.1992 |
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1337-1343 |
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health promotion |
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Concern is increasing among surgeons and operating theatre staff about the risks of occupational exposure to HIV and hepatitis viruses.’-6 There has also been much public debate about the risk of patients who undergo invasive procedures acquiring these viruses from infected surgeons.7 Eminent bodies have published reports on the topic, yet views vary about the risk of transmission of HIV8-’4 and the level of precautions appropriate to British hospitals.’59 It was against this background that in October 1991 the Hospital Infection Society and the Surgical Infection Study Group convened a one day workshop at the Royal Society of Medicine, London, to review the degree of risk and prepare practical guidelines for surgeons, anaesthetists, and health care workers working in operating theatres. Its report forms the basis of the recommendations presented below. The incidence of nosocomially acquired hepatitis far exceeds that of HIV infection. Hepatitis B is preventable with immunisation and hence is discussed first. |
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0959-535x; 0959-8146 |
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50-02844 |
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59764 |
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Titti, F.; Rezza, G.; Verani, P.; Butto, S.; Sernicola, L.; Rapicetta, M.; Sarrecchia, B.; Oliva, C.; Rossi, G. B. |
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Title |
HIV, HTLV-1, and HBV infections in a cohort of Italian intravenous drug abusers: analysis of risk factors |
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Year |
1988 |
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Journal of acquired immune deficiency syndromes |
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1 |
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405-411 |
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health promotion |
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Summary: A seroepidemiological survey of a group of 291 intravenous drug abusers (IVDAs), 45 household contacts of IVDAs, and 39 laboratory workers has been carried out to determine the prevalence of HIV-1, HIV-2, HTLV-1, and HBV antibodies in the sera, as well as to evaluate the role of various risk factors. Among i.v. drug abusers, the prevalence was 32.3% for HIV-1 and 6.6% for HTLV-1. For both viruses, the total figures did not significantly change from 1985 through 1987, accounting for a slow viral circulation in this group. No seropositivity (HIV-1, HTLV-1) was found among laboratory workers, whereas one subject was found seropositive for HIV-1 among household contacts. From 1985 to 1986, 5 out of 58 subjects seronegative for HIV-1 and 5 out of 82 seronegative for HTLV-1 seroconverted (incidence rates of 8.6 and 6.1%, respectively). From 1986 to 1987, none out of 11 seronegatives for HIV and 1 out of 16 seronegatives for HTLV-1 seroconverted. The total figures for hepatitis B markers were 79.2% among IVDAs, 24.4% among household contacts, and 25.6% among laboratory workers. A significant correlation was found between presence of HBV markers and seropositivity for HIV and HTLV-1. A significant association with HIV-1 seropositivity was found for history of sexual intercourse with HIV-1 seropositive partners and for sexual promiscuity. These data emphasize the important role played by sexual behavior in addition to needle-sharing in the spreading of multiple infections among drug abusers. |
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50-02837 |
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59762 |
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Author |
Stark, Klaus; Muller, Reinhold; Bienzle, Ulrich; Guggenmoos-Holzmann, Irene |
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Title |
Frontloading: a risk factor for HIV and hepatitis C virus infection among injecting drug users in Berlin |
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Journal Article |
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Year |
1996 |
Publication |
Aids |
Abbreviated Journal |
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10 |
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311.317 |
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health promotion |
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Objective: To determine whether frontloading (i.e., syringe-mediated drug-sharing) is a risk factor for HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among injecting drug users (IDU). Design: Cross-sectional study. Data on sociodemographic and behavioural characteristics were obtained by a standardized questionnaire. Serum samples were tested for seromarkers for HIV, HBV and HCV. Setting and participants: IDU were recruited at ’low-threshold’ storefront agencies (out-of-treatment sample), and at a centre for long-term drug use treatment (in-treatment sample). Individuals were included in the study if they had injected drugs within the previous 3 months. Main outcome measures: Serological evidence for HIV, HBV, HCV exposure. Results: Of all IDU (n = 324), 84% had ever practised frontloading with non-sterile injecting equipment, and 46% had done so more than 100 times; 32% had front-loaded during the 6 months prior to the interview. The crude seroprevalence rates for HIV, HBV and HCV increased with the overall frequency of frontloading, and reached 22, 71 and 94%, respectively, among IDU who had frontloaded more than 100 times. After controlling for confounding effects by logistic regression, having practised front-loading more than 100 times was significantly associated with HIV infection [adjusted prevalence odds ratio (POR) 3.5; 95% confidence interval (CI), 1.4-9], and HCV infection (adjusted POR, 5.4; 95% CI, 2.3-12), but not with HBV infection. Another independent risk factor for all three virus infections was needle-sharing in prison. Conclusions: In communities where sterile injection equipment is readily available, and IDU have substantially reduced their overall levels of needle-sharing, the practice of frontloading appears to be a major risk factor for infections by blood-borne viruses among IDU. Prevention activities should specifically address this risk behaviour. |
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0269-9370 |
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50-02835 |
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59760 |
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Somaini, Bertino; Wang, Jen; Perozo, Malile; Kuhn, Fredy; Meili, Daniel; Grob, Peter; Flepp, Markus |
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A continuing concern : HIV and hepatitis testing and prevalence among drug users in substitution programs in Zurich, Switzerland |
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Year |
2000 |
Publication |
AIDS Care |
Abbreviated Journal |
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12 |
Issue |
4 |
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449-460 |
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health promotion |
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Phase I of the Zurich Prometheus Study is a cross-sectional study focusing on an up-to-date serology for HIV and hepatitis B/C and associated risk factors for all clients in four participating clinics offering opiate substitution in Zurich, Switzerland. The mean age of the 603 respondents is 30.7 years (SD=6.2), and 38% of them are women. Seventy-five percent of the respondents have a history of injecting drug use (IDU), and over half have injected within the past six months. Lab-confirmed seroprevalence for HBV (50%) and HCV (57%) is twice that of HIV (24%). There is an 80% risk reduction for all three viral infections among those starting IDU after 1991—when harm reduction efforts were in full swing—compared to those who began before 1988—before clean needles were widely available. These findings suggest a strongly protective effective of harm reduction measures. But while a stabilization in HIV prevalence at 15% can be seen among drug users who started injecting after 1991, prevalence rates for HBV and HCV still remain several times higher. The prevalence data in this study support data showing continued high incidence rates for HBV and HCV, even among new injectors in the harm reduction era. |
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Call Number |
50-02834 |
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59759 |
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Author |
Rhodes, Tim; Hunter, Gillian M.; Stimson, Gerry V.; Donoghoe, Martin C.; Noble, Alison; Parry, John; Chalmers, Colin |
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Prevalence of markers for hepatitis B virus and HIV-1 among drug injectors in London : injecting careers, positivity and risk behaviour |
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Journal Article |
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Year |
1996 |
Publication |
Addiction |
Abbreviated Journal |
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Volume |
91 |
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10 |
Pages |
1457-1467 |
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health promotion |
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Concerns about the risks of HIV infection among drug injectors have eclipsed concerns about the prevalence and transmission of hepatitis, and in particular hepatitis B virus infection. Findings are reported from surveys undertaken with two separate community-recruited samples of drug injectors in London collected in 1992 (n = 505) and in 1993 (n = 507). Anonymized confirmed testing of saliva snows 51.5% of drug injectors in 1992 and 47.9% in 1993 to be antibody positive to the core antigen of hepatitis B virus (anti-HBc). Approximately half of the drug injectors confirmed as anti-HBc positive were unaware that they had been infected with hepatitis, Anti-HIV-1 prevalence was considerably lower at 7.0% in 1992 and 6.9% in 1993. Multivariate analyses showed anti-HBc positivity to be most likely among older injectors with longer injecting careers who had a history of having shared used needles and syringes. HIV-1 positivity was also associated with a history of having shared injecting equipment as well as with recent sharing (i.e. in the last 6 months). Unlike anti-HBc positivity, there were no associations between HIV-1 positivity and age or length of injecting career. Younger injectors with shorter injecting careers were more likely to report recent sharing of used injecting equipment than older injectors with longer injecting careers. We note the potential for continued transmission of HBV and HIV-1, particularly among younger injectors. We recommend an integrated strategy to maximize the health of drug injectors, of which HIV and HBV prevention is a part. There is a need to widen the availability of HBV vaccinations for HBV negative drug injectors and their sexual partners and for clear guidelines to drug injectors about the relative efficacy of bleach to disinfect injecting equipment of HBV and HIV. |
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0965-2140 |
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Pages 1457-1458 are missing. |
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50-02833 |
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59758 |
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Author |
Edlin, Brian R. |
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Prevention and treatment of hepatitis C in injection drug users |
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Journal Article |
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2002 |
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Hepatology |
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36 |
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5b |
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210-219 |
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health promotion; HIV infection; Aids |
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Injection drug users constitute the largest group of persons infected with the hepatitis C virus (HCV) in the United States, and most new infections occur in drug users. Controlling hepatitis C in the U.S. population, therefore, will require developing, testing, and implementing effective prevention and treatment strategies for persons who inject drugs. Fortunately, a substantial body of research and clinical experience exists on the prevention and management of chronic viral diseases among injection drug users. The need to implement interventions to stop the spread of HCV among drug users is critical. The capacity of substance-use treatment programs need to be expanded to accommodate all who want and need treatment. Physicians and pharmacists should be educated in how to provide access to sterile syringes and to teach safe injection techniques, both of which are lifesaving interventions. The treatment of hepatitis C in drug users requires an interdisciplinary approach that brings together expertise in treating hepatitis and caring for drug users. Treatment decisions should be made individually by patients with their physicians, based on a balanced assessment of risks and benefits and the patient’s personal values. Physicians should carefully assess, monitor, and support adherence and mental health in all patients, regardless of whether drug use is known or suspected. Research is needed to better understand how best to prevent and treat hepatitis C in substance users. In the meantime, substantial progress can be made if existing knowledge and resources are brought to bear. |
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1527-3350 |
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50-02829 |
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59757 |
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Author |
Crofts, Nick; Nigro, Luciano; Oman, Kimberly; Stevenson, Elaine; Sherman, John |
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Research Report : Methadone maintenance and hepatitis C virus infection among injecting drug users |
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Journal Article |
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Year |
1997 |
Publication |
Addiction |
Abbreviated Journal |
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92 |
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8 |
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999-1005 |
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health promotion; HIV infection; Aids |
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Harm reduction strategies for the prevention of transmission of human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs) have been widely implemented in Australia and are seen to have been effective in preventing the spread of HIV. A major strategy has been increasing the availability of and accessibility to methadone maintenance therapy (MMT) programmes. We have reviewed the experience of a major MMT general practice with hepatitis C virus (HCV) infection from 1991 to 1995. Of 1741 individuals tested for HCV antibodies at least once 66.7% were positive. Of 73 IDUs who were initially seronegative and were retested at least once, 19 were subsequently seropositive. Seroconverters to HCV were younger than non-seroconverters, and were more likely to have evidence of previous hepatitis B infection. The overall HCV incidence rate was 22 cases per 100 person-years, and this did not differ between those on MMT programs (continuous or interrupted) between HCV tests and those not on MMT. These findings suggest that the role of MMT in the control of the spread of HCV infection among IDUs needs further assessment, and that control of the current epidemic of HCV infection among IDUs in Australia will be very difficult. |
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0965-2140 |
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50-02827 |
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59756 |
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Coppola, R. C.; Manconi, P. E.; Piro, R.; Di Martino, M. L.; Masia, G. |
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HCV, HIV, HBV and HDV infections in intravenous drug addicts |
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Journal Article |
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1994 |
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European Journal of Epidemiology |
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10 |
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279-283 |
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health promotion; HIV infection; Aids |
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Hepatitis viruses and the acquired immunodeficiency viruses often infect intravenous drug addicts (IVDAs). Our study includes 255 IVDAs (26 females and 229 males, aged 20–35 years) from Cagliari. Of 255 subjects examined, 207 (81.1%) were positive for anti-HCV and 84 (32.9%) for anti-HIV. Nineteen (7.4%) subjects were HBsAg carriers, and 12 of these (63%) had an HDV super-infection. Markers of previous HBV infections were tested in 223 cases and 137 (61.4%) were found positive; of these 14 (10.2%) also had HDV infection. Of the 223 drug addicts examined for all infection markers, 18 (8%) were negative to all markers, 46 (20.6%) were positive to only one, 89(39.9%) were positive to two, 64 (28.7%) to three and 6 (2.6%) were positive to all. Subjects with a single infection were significantly fewer than those with multiple infections. The correlations studied among the various markers did not point out any statistically significant associations. Even so, a previous HBV infection was more common while active HBV/HDV infections were less common among subjects with anti-HCV; HDV infection was more common among HIV-positive subjects. In HBsAg carriers neither HBV-DNA nor HCV-RNA was detected; HCV-RNA was found more frequently in anti-HIV positive subjects than in subjects with the anti-HCV isolate. |
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0393-2990 |
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50-02826 |
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59755 |
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Soriano, Vincent; Sulkowski, Mark; Bergin, Colm; Hatzakis, Angelos; Cacoub, Patrice; Katlama, Christine; Cargnel, Antonietta; Mauss, Stefan; Dieterich, Douglas; Moreno, Santiago; Ferrari, Carlo; Poynard, Thierry; Rockstroh, Jürgen |
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Care of patients with chronic hepatitis C and HIV co-infection: recommendations from the HIV-HCV international Panel |
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2002 |
Publication |
Aids |
Abbreviated Journal |
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16 |
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813-828 |
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health promotion; viral hepatitis; hepatitis C; HIV infection; Aids |
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0269-9370 |
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50-02764 |
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59750 |
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